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[Pleural plaques and an asbestos environment in Northern Corsica].

As opposed to North-West Corsica, North-East Corsica is rich in asbestos outcrops and a source of environmental pollution as can be seen in the airborne concentration of chrysotile and above all tremolite. We have composed the frequency of asbestos pleural plaques occurring in subjects in the two regions starting with a retrospective analysis of the radiological records of 1,721 patients born in Northern Corsica and having no occupational exposure to asbestos. The frequency is 3.8% in the North-East and 1.1% in the North-West (p less than 5%). The relative East-West risk, which is 3.3%, shows the existence of a link between pleural plaques and environmental exposure to asbestos in North-East Corsica.

Aged↗

[Lessons from a long-term survey on the effects of massive occupational exposure to asbestos. The AMISOL affair 10 years later].

For the past 10 years the authors have followed up a cohort of workers who had been massively exposed to dust in an asbestos textile factory which closed down in 1974. They report on the difficulties of all kinds they encountered during this epidemiological survey. The most original result is that they were able to establish that the radiological and functional manifestations of asbestosis pursue their course after the subjects have ceased to be exposed. Another important point is the early development of lesions in peripheral bronchioles, detected by volume-flow loops. The authors insist on the psycho-social problems at the site of work or in daily life which arise from the use of asbestos or of fibres with similar properties. Social protection, at present well organized, should suppress the risk of asbestosis in Western countries. However, a number of problems remain to be solved, notably those concerning the long-term risk of pleural mesothelioma, the mode of action of the fibers and the immune reactions they induce, and the economic and social consequences of a hypothetical ban on asbestos--a material very difficult to replace. This study embodies, in miniature, all the problems of society associated with asbestos during this second half of the XX th century.

Asbestosis↗

The incidence of asbestos bodies in the lungs at random necropsies in Montreal.

The incidence of asbestos bodies in the lungs of adult patients selected at random, who died in four Montreal hospitals, was studied by examining fresh unstained smears of lungs obtained at necropsy. Two techniques were used for preparation of the smears and an arbitrary grading system was developed to estimate the degree of contamination of the lungs by asbestos bodies.Asbestos bodies were present in 48 out of 100 necropsies; they were found in 32 of 56 men (57%) and in 16 of 44 women (34%). Men were more heavily contaminated. The proportion of positive smears depended on the technique used and the amount of lung sampled. No particular association was noted between asbestos bodies in the lungs and the presence of cancer in the 33 patients in this series with malignant disease. The high incidence in this random series suggests that asbestos is a significant air contaminant in Montreal.

Adult↗

Pleuropulmonary disease among asbestos workers in relation to smoking and type of exposure.

The chest roentgenograms of employees aged 40 and over in two asbestos manufacturing plants were read by consensus without knowledge of the plant or smoking habits. Plant A used only chrysotile asbestos throughout its history and Plant B used amosite as well as chrysotile, the amosite being limited to the period 1950-64. The prevalence of pulmonary disease was 25% in Plant A and 33% in Plant B. The prevalence of pleural thickening was 18% in Plant A and 35% in Plant B. Neither age nor work duration were factors in these differences. In Plant A there was no obvious relationship between smoking and pleuropulmonary disease. In Plant B there was a definite relationship of smoking to pulmonary disease and perhaps to pleural thickening. Both type of asbestos and smoking habits appear to be determinants of pleuropulmonary disease in asbestos workers.

Adult↗

[Asbestos pathology: clinical aspects epidemiological data and prevention].

The word "asbestos" is used to designate the main commercial types of asbestos (chrysotile, crocidolite, amosite) but there exist numerous asbestiform fibrous minerals, which are commercially valueless but widespread at the surface of the earth. Among them zeolite has already created health hazards in Turkey. Measurement of fibres in air and in tissues can contribute to a better knowledge of lung and body fibre burden associated with diseases. Among fibre-related diseases, studies have recently focused on clinical, epidemiological and pathogenic aspects of pleural fibrosis and lung or pleural cancer. At present the roles of the different types of fibres in the genesis of these diseases remain controverted. However, tobacco smoke associated with inhaled asbestos fibres provokes a multiplied risk of lung cancer. Regarding asbestos there exist regulations in most industrial countries designed to protect workers and diminish environmental pollution.

Air Pollution↗

Compensation of occupational diseases and particularly of asbestos-related diseases among the European Community (EEC) countries.

The aim of the paper is to present some of the characteristics of the compensation systems in EEC countries and to focus on the compensation of asbestos-related diseases: for each country the diseases admitted for compensation, the date of introduction into the schedule, the number of compensations awarded and a comparison between compensations for mesothelioma and mortality are presented. The data have been collected in 1990-91 by asking for information to the Compensation Institutes. The results suggest that the objective of harmonisation of the compensation systems among European countries is far from being achieved and needs re-vitalisation. The gap between knowledge and public health action has been considerable in the compensation of asbestos-related diseases, especially in the compensation of cancers. The results confirm, therefore, from a different perspective the validity of considering asbestos as a case study in public health. Finally, the Authors stress the serious situation in Italy with respect to updating the list of prescribed diseases as epidemiological data are available and to compensating occupationally related asbestos diseases.

Asbestosis↗

[Diagnosis with high resolution computerized tomography of early asbestos-induced diseases].

This study was aimed at investigating the possibility of detecting lung and pleural asbestos-related lesions by means of conventional chest films and high-resolution Computed Tomography (HRCT) in a study population of asymptomatic workers of a shipyard factory in northwestern Tuscany, Italy. Thus, a blind study was carried out by two radiologists who reviewed 144 conventional chest films previously considered as negative by outside readers. Thirty-eight of 144 workers were selected, whose conventional films had been confirmed as negative, together with 34 more subjects with suspected pleural plaques or mild parenchymal involvement (ILO profusion score: 0/1). These 72 subjects were submitted to HRCT: 19 of them were negative, while in 33 cases pleural plaques were found; 7 workers exhibited parenchymal involvement alone, while in 13 both pleural and parenchymal alterations were found. HRCT findings were correlated with the duration of amosite exposure and the latency time since first exposure. Relative to conventional radiographs, the threshold of exposure and latency times allowing asbestos-related diseases to be demonstrated was markedly lower. Our study suggests that pleural and/or lung involvement in asbestos-exposed workers can be shown by HRCT before the onset of clinical symptoms or the appearance of pleural/parenchymal involvement on chest films. Moreover, the HRCT-detectable lung and/or parenchymal involvement appeared to be related to exposure and latency times, as in most of clinically-apparent asbestos-related lung diseases.

Adult↗

Hyaline splenic and hepatic plaques. Correlation with cirrhosis, pulmonary tuberculosis, and asbestos exposure.

Nine hundred twenty-five unselected autopsies were investigated for the presence or absence of hyaline peritoneal (splenic or hepatic) plaques, hyaline pleural plaques, asbestos, liver cirrhosis, heart failure, previous peritoneal dialysis or abdominal surgery, chronic peritonitis, splenomegaly, splenic infarcts, and pulmonary or abdominal tuberculosis. Lung asbestos body concentrations were calculated in 570 subjects. Peritoneal plaques were recorded in 163 cases. In both univariate and multivariate analyses, they were associated with cirrhosis, pulmonary nonactive tuberculosis, pleural plaques, and asbestosis. Association with asbestos body counts was also found, with a significant trend. Peritoneal plaques were described long ago in different pathologic conditions, for some of which (cirrhosis and nonactive pulmonary tuberculosis) the association is confirmed by the present analysis. It is suggested that they are significantly associated, moreover, with indicators of asbestos exposure.

Adult↗

Autopsy evaluation of asbestos exposure: retrospective study of 135 cases with quantitation of ferruginous bodies in digested lung tissue.

In recent years, there has been increased interest in documenting asbestos exposure. The pathologic sine qua non of asbestos exposure has been the presence of "asbestos bodies" in lung parenchyma. In this retrospective study of 135 autopsies done to determine asbestos exposure, ferruginous bodies in digested lung tissue were quantitated by a simplified sodium hypochlorite procedure on fresh or fixed tissue. Of the 131 digested specimens, 26 (20%) showed no ferruginous bodies, 34 (26%) had <5 ferruginous bodies per slide, 7 (5%) had 5 to 10 ferruginous bodies per slide, and 64 (49%) had >10 ferruginous bodies per slide. Ferruginous bodies were identified in hematoxylin-eosin stained sections of lung tissue in only 41 cases (30%). The digestion method described is a simple, reliable, and inexpensive method to assess ferruginous bodies.

Adult↗

Diachronic study of pleural plaques in rural population with environmental exposure to asbestos.

BACKGROUND: The progress of pleural plaques in persons exposed to environmental asbestos in Almopia, Greece were studied prospectively. METHODS: During a 15-year period, 198 individuals, in whom pleural plaques had been observed during the period 1988-1990 were followed. Respiratory function was initially evaluated in 23. All were inhabitants of seven villages of Northern Greece, where rocks with high concentration in asbestos fibers were used for whitewashing until 1935. RESULTS: Out of this population, 126 survived and underwent chest X-ray in 2003 while respiratory function was retested in 18. New radiological findings were compared to previous ones using digital technology. Furthermore, the cause of death of the remaining 72 was recorded. Deterioration of X-ray findings was observed in all survivors. Not only did the surface area of previous plaques increase (8.66 +/- 12.6 cm2, mean value +/- SD) but new ones also appeared. Total lung capacity decreased from 95.6 +/- 14.8 in 1998 to 76.5 +/- 9.3% predicted in 2003. It was found that out of 72 deaths, 11 people died of malignant lung neoplasm, and 4 of mesothelioma. CONCLUSIONS: Radiological appearance of pleural plaques and respiratory function of people previously exposed to asbestos environmental pollution worsens over the years. Prevalence of mesothelioma was found to be higher than expected.

Adult↗

Asbestos dust exposure during brake repair.

About 10,000 tons of chrysotile per year are used in the Federal Republic of Germany for the production of friction materials. During brake repair an unknown number of approximately 300,000 mechanics in automobile service stations are exposed to asbestos dust. In a field study, asbestos fiber concentrations during brake repair were measured. Occupational histories and chest X-rays of brake service mechanics are being examined. Ninety dust measurements in 76 service stations were made by phase contrast microscopy and by scanning transmission electron microscopy. By electron microscopy, extremely fine chrysotile fibers with lengths less than 5 microns were identified in brake drum dust. Fibers with lengths greater than or equal to 5 microns constituted less than 1% of all chrysotile fibers counted in brake drum dust. Short-term asbestos dust exposures were measured by light microscopy in 101 personal samples during blowing out of brakes, and grinding and turning of brake linings. During blowing out of car brakes, as well as during grinding of brake linings, the product of fiber concentration with length greater than 5 microns and sampling time amounted to about 4-5 fibers/ml X min corresponding to a concentration of 10(6) fibers/m3 over 4-5 min. For trucks and buses higher amounts of 5-10 X 10(6) fibers/m3 X min were observed during these operations. From occupational histories of 210 vehicle mechanics, an average duration of employment of mean +/- s = 21 +/- 10 years and a mean cumulative fiber dose of mean +/- s = (0.54 +/- 1.1) X 10(6) fibers/m3 X years were calculated.

Air Pollutants, Occupational↗

Accumulation of long asbestos fibers in the peripheral upper lobe in cases of malignant mesothelioma.

Animal studies suggest that mesothelioma is most effectively induced by fibers longer than 8 mu. However, studies of asbestos fibers recovered from human lungs in cases of mesothelioma indicate that, at least in large-scale samples, relatively few fibers meet this size criterion, perhaps implying that the animal data do not apply to man. Since asbestos concentration in lung is known to be extremely inhomogeneous, it is also possible that long fibers may selectively accumulate in specific sites, such as under the pleura. To examine this possibility, we selected ten cases of mesothelioma that contained relatively large amounts of amosite asbestos and extracted fibers from an 0.5-cm-thick strip of subpleural tissue and an area 3-cm deep to the subpleural sample for upper and lower lobes. Amosite fibers were identified and sized by electron microscopic techniques. Fibers in the peripheral upper lobe were significantly longer, broader, and of higher aspect ratio than those in the central upper lobe. The lower lobe showed a reverse pattern, with longer fibers and broader fibers in the central sample. These data indicate that the two lobes behave differently in regard to fiber size, with selective accumulation of long fibers in the peripheral upper lobe, but not in the peripheral lower lobe. Whether these differences reflect differences in initial deposition of fibers within the lung, or, more likely, specific redistribution of fibers, is unclear, but in either case, accumulation of long fibers immediately under the upper lobe pleura may be important in the genesis of mesothelioma.

Asbestos↗

Response of mouse lung to crocidolite asbestos. 1. Minimal fibrotic reaction to short fibres.

To determine the relationship between the development of pulmonary fibrosis and the size of deposited asbestos, we prepared a pure sample of short crocidolite fibres and instilled 0.5 mg of 0.1 mg to the lungs of mice. Animals were killed up to 20 weeks later with 3H thymidine injected 1 h before death. By bronchoalveolar lavage, there was a rapid transient increase in polymorph neutrophils (PMN) and in glucosaminidase levels; alveolar macrophage (AM) numbers were elevated in the 0.5 mg group for eight weeks. Most fibres were phagocytized by AM, many of which were heavily laden and cleared from the lung over the 20 week period. Some fibres were seen in type 1 epithelial cells, frequently associated with cell injury. From cell kinetic studies, a very brief proliferative response was seen in bronchiolar epithelial and Type 2 alveolar epithelial cells. A greater response was seen in interstitial fibroblasts which showed increased labelling up to two weeks after 0.5 mg asbestos. However no granulomas were seen and very little fibrosis was found by morphology or by biochemistry at any time after 0.5 mg; no fibrosis was seen after instilling 0.1 mg. The results show that a high dose of exclusively short asbestos fibres produces minimal lung injury and fibrosis in spite of long standing macrophage-fibre interaction in the alveoli.

Animals↗

Free radical generation during interaction of chrysotile asbestos with natural compounds.

Free radical generation was found after the addition of some natural biological substances (adrenaline, ascorbate, ubiquinone Q9, etc.) to a chrysotile asbestos suspension. This was detected by the chemiluminescent method with lucigenin as an indicator. The detailed study of the chemiluminescent reaction in the adrenaline-chrysotile system indicated that the reaction required hydroxyl ions, which arose in the chrysotile suspension, and was accompanied by a superoxide radical formation. At the same time, the radical production was very low in suspensions of amphybole asbestos, talc, and quartz, which could not alkalinize the water medium. On the basis of these results, it may be concluded that chrysotile has a unique ability to generate free radicals upon interaction with some biological molecules in a water medium. This fact may explain the great carcinogenicity of chrysotile. The injection of cigarette smoke solution into chrysotile (but not into amphibole asbestos or talc) suspension induced intensive chemiluminescence. This suggests that smoke aggravates the effect of chrysotile on human health by increasing free radical generation on the surface of the fibers.

Asbestos, Amphibole↗

Quantitative detection of asbestos fiber in gravelly sand using elastic body-exposure method.

Chrysotile or crocidolite colloidal solution containing donor plasmid DNA and Escherichia coli cells was subjected to elastic body friction. These acicular clay minerals mediated E. coli antibiotic resistance plasmid transformation. Other clay minerals had no effect on E. coli transformation. The number of E. coli transformants was counted after elastic body exposure with various crocidolite concentrations. There was a correlation between the number of E. coli transformants and crocidolite concentration (between 40 and 1,000 ng/ml). A mixture consisting of sea sand and crocidolite was utilized as a model for quantitative detection of asbestos in gravelly sand. With sea sand containing 0.15-15 mg of crocidolite, a correlation between crocidolite concentration and the number of colonies derived from E. coli transformants was observed. This indicates that measurement of asbestos is possible even when the asbestos sample includes gravelly sand. Fluorescence microscopic observation of crocidolite colloidal solution indicated that crocidolite was present as spherical aggregates having diameters of 6-9 microm. Thus, the number of transformants correlated with that of 6-9 microm crocidolite aggregates.

Aluminum Silicates↗

Cytotoxicity of a short-fiber chrysotile asbestos for human alveolar macrophages: preliminary observations.

Studies were performed to compare the cytotoxicity for human alveolar macrophages of a naturally occurring short-fiber chrysotile asbestos (RG 144) to that of a standard reference mixed-fiber (long and short) chrysotile asbestos (UICC chrysotile A. Rhodesian). Parallel studies were also performed with quartz (Min-U-Sil 15), a known macrophage toxin. On a mass basis, and after 24 hr incubation, RG 144 was more cytotoxic than the UICC standard reference fiber and less toxic than quartz (silica). The cytotoxic potential of RG 144 chrysotile was further enhanced after size reduction by milling. These findings may have important biologic implications with respect to the use of short-fiber asbestos in industry.

Adult↗

Pulmonary cytology in chrysotile asbestos workers.

The prevalence of atypical cytology has been determined in relation to age, smoking and asbestos exposure for male workers employed in 3 mines in the Province of Quebec. Overall participation was 71%. Out of 867 participating workers, 626 (72%) presented a deep cough specimen within normal limits, 74 (8.5%) a specimen with mild atypical metaplasia and 10 (1.2%) a specimen with moderate atypical metaplasia. Four lung carcinoma were identified. Five percent of the workers initially interviewed did not return their specimen and 12.7% had unsatisfactory test results. Proportions of cellular atypia increased with age and asbestos exposure. Using logistic regression analysis, estimated probabilities of abnormal cytology for workers aged 25 years when started mining increased with both years of asbestos exposure and exposure index measured in fibres per cubic centimeter.

Adult↗

Bone marrow alterations induced in mice with inhalation of chrysotile asbestos.

The effect of chrysotile asbestos exposure on bone marrow and immune parameters was examined in mice at 2, 12, and 26 weeks following a 3-day inhalation exposure. Ultrastructural examination revealed that the fibers were deposited primarily at alveolar duct bifurcations within the centriacinar region of the lung. Histological pulmonary changes were minimal, but by 26 weeks early asbestosis characterized by clusters of macrophages and minimal fibrosis were present in the centriacinar region of the lung. Lymphoproliferative responses, antibody levels, and number of plaque forming cells were not significantly altered in exposed mice. Pulmonary macrophages, but not peritoneal macrophages, showed evidence of activation in the chrysotile-exposed mice at 26 weeks following exposure. The most striking change was the depression of the number of bone marrow pluripotent stem cells (CFU-S) and marrow granulocyte macrophage progenitors (CFU-GM) which were lower at all three postexposure examinations. It is felt that the depression of bone marrow progenitors in asbestos-exposed mice may have relevance to the leukopenia reported in workers with occupational history of asbestos exposure.

Animals↗